"Weaknessesare not wanted"

After the death ofRobert Enke,Germany is still in shock.At a press conferenceTeresaEnkeandthe attending PsychotherapistDr.Markserstated thatthe keepersuffered from depression, which they claim as reasonforhissuicide.

Ms. Pfaff, everyone knows the conception of "depression". Can you tell us what it is exactly ?First, I must mention that I am not a psychotherapist, but through my studies of psychology and sport psychological work I know about depression and it's forms. Depression belongs to area of the affective disorders.

And what forms are there ?There is the unipolar disorder. A person has a negative, depressive mood, is low on energy and loses the joy and interest in life. This sentiment runs in more or less long periods, which can be triggered by problems or crises. On the other hand there is the bipolar disorder, with manic-depressive episodes. Peoples moods shift from joyful to sorrowful and at worst suicidal.

RobertEnke'sattending physiciantold the pressthat he did follow atypicalendogenoustherapy.What does that mean ?Endogen stems from the inside, i.e. a genetical predisposition. Exogenous means from the outside, caused by external factors. Robert Enke repeatedly lived through personal and sporting crises that seem to hurt him internally.

What happens, when a depressed person closes the door behind him ?Depression affects the whole life of a person. It starts when you get up. Patients barely can get out of bed, sit in a corner, have no energy, are listless and have dark thoughts. Life with a person in a depressive phase is very difficult. You can hardly activate them. If, as in the case of Enke, coming back from training, he might get a bit of momentum. But any enthusiasm evaporates quickly and the persons energy collapses again.

His environment described Enke as a sensitive person.From the reports about Robert Enke we can conclude that he was sensitive, but also more vulnerable than other athletes and other people. This suggestion fits with him seeking treatment for fear of failure. With the help of psychotherapy, the patient wants to cope with personal problems. Although these treatments generally are subject to discretion, I think it is useful to include family and friends to cope.

Should Robert Enkehavepublicly confessed his illness ?This question is difficult for me to judge as an outsider. A public confession is indeed admitting a weakness. In our competitive society a top athlete has to show strength - especially being "No. 1", the number one goalkeeper in Germany. In this situation it doesn't seem helpful to reveal weaknesses.

Especially since he was afraid of losing his sport and his adopted daughter.Exactly.

Did professional soccer, which extremely builds on strength, have a negative effect on Enke ? As a former professional athlete you know what pressure feels like ?When you compete publicly, you have to be strong and perform. That is simply required. Weaknesses are not welcome in our meritocracy. Professional athletes are afraid that weaknesses could be exploited. In this respect one shows strength, or acts strong. No coach wants a player saying, "I feel bad". Especially in a team sport, you got to stand up for the team and yourself. Therefore, it is difficult to open up and tell people the whole truth.

Also, because depression is still a taboo subject in society. But statistics show that every fifth German suffers from depression once in a life-time.In society a new thinking must precede. If someone confesses to his illness, his weakness cannot be exploited. Although it is good to perform on a high level, but society must show humane traits. We are no machines. Despite the performance, we are sometimes fragile.

Why didn't psychologists at Hannover 96 or at the DFB take notice of his illness ?I lead many interviews as sports journalist and had many conversations as psychologist. But my guess is, nobody told me "the whole catastrophy". There are always barriers, even if someone feels really bad. There are certain sentences that make psychologists listen. But you have to remember that the psychologists who work in teams, are not trained necessarily therapeutically.

Why ?Sports psychologists are recruited from the field of sports science and psychology. A psychiatrist is a doctor who can prescribe medication. A sports psychologist is not authorized to work therapeutically. Patients with depression are usually treated with medication and psychotherapy, which is the most common method.

Teresa Enke said soccer was Enkes elixir of life. Is it more difficult for an athlete when he bears the end of his career in mind ?As long as things run well in sports, an athlete usually feels good. Depressive states vary in their strength and intensity. If sports is the elixir of life like in Enke's case, on the field he probably felt comfortable and relaxed and could leave depressive symptoms behind. Sport acts as a kind of antidepressant, but negative sentiments unfortunately remain in a negative phase. Enke was doing well in sports - until his disease took over. He was a goalkeeper and had a prospect of the World Cup in the following year. But crises and problems can quickly trigger depressive phases in vulnerable people. In these times of crisis suicidal thoughts also must have come up.

Are suicidal thoughts a constant companion ?Suicidality is one of the symptoms of depression and therefore thoughts and plans of suicide must be taken absolutely seriously.